Video-Thoracoscopic Parietal Pleurectomy

Abstract

Pleurectomy implies removal of the parietal and/or visceral pleura and can be performed by video-assisted thoracic surgery (VATS) or open thoracotomy. Depending on the specific disease involved, an apical, partial or full parietal pleurectomy is performed. In case of a thickened visceral pleura limiting lung expansion, a visceral pleurectomy which is called decortication may be necessary.

Main indications for pleurectomy are primary or secondary spontaneous pneumothorax, recurrent pleural effusion associated with inflammatory disorders and malignant pleural effusion. For most indications, no definitive guidelines can be provided due to the lack of prospective randomised clinical trials. Specific treatment should be tailored according to the patients’ symptoms, the underlying disease and the estimated prognosis.